Motor Outcomes in Premature Infants

Maureen Connors Lenke, BS, OTR/L

Disclosures

NAINR. 2003;3(3) 

In This Article

Abstract and Introduction

Motor impairment is frequently associated with prematurity. Many of the early signs of a significant motor deficit in the premature infant will be transient and resolve during the first year of life. However, despite medical advances in the neonatal intensive care unit, the incidence of cerebral palsy is reported at 32% in infants weighing less than 1,500 grams. The developmental progression of the premature infant, including early differences between full-term and preterm infants, that affects motor examination; factors that predispose premature infants to neuromotor deficits; and the long-term implications of premature birth from a motoric perspective, will be addressed.

Follow-up assessment of the high-risk infant has evolved in response to the dramatic increase in the survival rates of very low birth weight babies. Despite advances in medical care, infants born prematurely continue to be at high risk of developing motor deficits. Birth weight and gestational age are critical factors in determining developmental outcomes. In general, the shorter the gestational period or the lower the birth weight, the greater the risk status for motor deficits in the premature infant. Very preterm birth (gestation less than 32 weeks) is a strong predictor of later cerebral palsy (CP).[1] It is reported that approximately 10% of the smallest (<1,000 grams) preterm infants will develop CP.[2] A recent study reported a 32% rate of CP in those infants weighing less than 1,500 grams.[3] Infants who demonstrate early motor impairments that resolve may also have subtle motor deficits that persist, which later impact school performance.[4] It is often difficult to determine which infants are more likely to recover from the consequences of prematurity and neonatal intensive care unit (NICU) hospitalization, so specialized follow-up examinations to detect early motor delays are very important in the care of the premature infant after discharge.

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